Workforce Development and Continuing Education Application

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Application Information

Name(Required)

First Last

Date of Birth(Required)

Social Security(Required)

Gender

Address(Required)

Street Address Address Line 2 City State ZIP Code

County of Residence(Required)

Cell Phone(Required)

Email(Required)

Driver's License #(Required)

State Driver's License Issued(Required)

State / Province / Region

Emergency Contact(Required)

First Last

Emergency Contact Phone(Required)

Do you receive SNAP Benefits?(Required)

Are you currently working?(Required)

If yes, please provide name of employer and position.

Where do you work?(Required)

When did you start work?(Required)

Demographic Questions

Please read carefully and answer the following questions:

Do you consider yourself Hispanic or Latino/a/x?(Required)

In addition to the above, select any or all of the following race classifications that you identify with:(Required)

African American/Black

American Indian

Alaskan Native

Asian

Caucasian/White

Hawaiian/Pacific Islander (Native)

Mixed Race

Other

Registration Information

Course/Program(Required)

Name of Course/Program

Start Date

End Date

Start Time

Campus/Location

Please press on the (+) on the right to add additional courses.

Documentation

Driver's License or State ID(Required)

Please provide a clear copy of a valid state driiver's license or state issued ID.

Max. file size: 125 MB.

High School Diploma, GED, Transcript(Required)

Please provide a clear copy of one if the following: high school diploma, GED, college transcript.

Max. file size: 125 MB.

Citizenship, Refund, Tuition and Work Policies

Please read and initial the following statements:

Consent(Required)

I, the above-named applicant, do hereby attest that I am a citizen of the United States of America (by birth or naturalization) or a legal permanent resident of the US, or an alien lawfully present in the US in compliance with the SC Illegal Immigration Reform Act (SC Code An.59-10-430 (Westlaw 2008). I understand that DTC may require documentation to support my status.

Consent(Required)

I also understand that the department of workforce development and continuing education does not issue refunds unless a class is cancelled by the department itself. If I am unable to continue the class after the first session, I understand that I am not entitled to a refund, but may be offered a credit towards another course offering.

Consent(Required)

I understand and agree that the funding provided for my education is intended to support my training for employment in the field of study. By accepting this funding, I commit to making a good-faith effort to seek and obtain employment in the field for which I am being trained upon completion of my program. I acknowledge that if I choose not to seek employment in the field of training or otherwise fail to fulfill this commitment without an approved exception, I will be required to repay the full amount of the funding to the college.

Consent(Required)

I recognize that tuition is due in full before the first class session. Failure to pay or make payment arrangements before the start of the course will result in removal from the course. Failure to complete any payment plan or arrangement by its deadline will result in ineligibility for the final exam, clinical, certificate of completion, and/or licensure exam and a grade of U – unsatisfactory.

Signature(Required)

Your Name
Your Name
Your Name

SCHOLARSHIP AWARD ACCEPTANCE/VERIFICATION FORM

We are pleased to inform you that you may be eligible for a scholarship. The scholarship will be applied to your account after you accurately complete, sign, and return this form showing that you meet the grant/scholarship requirements and the program attendance requirement (must attend the first day, not miss more than 10% of class hours, etc.). Please answer the following questions, sign the agreement below

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Country Phone Number

Email(Required)

Do you currently work?(Required)

Yes

Place of Employment & Location (Enter NA if not Employed)(Required)

Employment Start Date (Enter NA if not Employed)(Required)

Driver's License State & Numver(Required)

Do you consider yourself Hispanic or Latino?(Required)

Yes

Select each of the following race/ethnicity classifications that you identify with:

African American/Black

Alaskan Native

American Indian

Asian

Caucasian/White

Hawaiian/Pacific Islander (Native)

Mixed Race

Other

I am 18 years old or older.(Required)

Yes

I have lived in South Carolina continuously for 12 months or more as of today.(Required)

Yes

I am NOT in default on a Federal or State Student Loan.(Required)

Yes

I am currently working. (Answering “yes” does not prevent you from receiving a scholarship.)(Required)

Yes

I (my parent and/or child) receive(s) Food Stamps (SNAP).(Required)

Yes

I (my parent and/or child) receive EBT/TANF cash assistance(Required)

Yes

I am NOT working, so I agree to complete 100 hours of community service within 12 months of starting this course. (Instead of taking a financial literacy course.)(Required)

Yes

I am NOT working and will not be able to complete the community service will complete a financial literacy course provided by the college. (Instead of community service)(Required)

Yes

Household Size(Required)

Annual Household Income(Required)

Affirmation

I affirm that the responses on this form are an accurate reflection of my belief and circumstances. I agree to accept this scholarship and am subject to all relevant college, state, and federal policies related to it. I understand that I am individually responsible for program tuition, books, supplies, and related fees and that this or any other scholarship or payment arrangement may be rescinded if I become ineligible to complete the course.

Signature(Required)

Your Name
Your Name
Your Name

Date

Month

Day

Year

SC Wins Affidavit

SC Wins Scholarship covers tuition and fees after applying all other scholarships and grants for South Carolina residents enrolled in a qualified program. Award amounts may be adjusted or canceled due to changes in enrollment or the availability of funds. If I am a credit student, I understand that I must achieve and maintain a 2.0 cumulative Grade Point Average (GPA) for any renewal award(s). The maximum amount of SC Wins that can be awarded up to $5000 per academic year. Students enrolled in an associate degree can receive up to 3 years (9 terms in total) of SC Wins funding. Students enrolled in an industryrecognized credential, a certificate, or a diploma program, can receive up to 2 years (6 terms in total) of SC Wins funding.

Changing Majors

Changing majors is allowed within the acceptable disciplines in workforce program areas. However, it may result in losing the SC Wins Scholarship.

Name(Required)

First Last

Student ID(Required)

Academic Year(Required)

Email(Required)

Phone(Required)

Country Phone Number

Certification: I certify that I am: (Please check all that apply.)(Required)

a South Carolina resident.

currently enrolled in an eligible program.

Please certify one of the below:(Required)

I am currently employed.

I will complete a FREE one-hour financial literacy Course offered by DTC.

I will complete 100 hours of voluntary time contributing to a non-profit or public service organization.

Additional Certification(Required)

I certify that while receiving SC Wins for a credit hour program, I cannot receive the equivalent amount in a continuing education program. I also understand that the maximum amount of SC Wins I can receive is up to $5000 per year, whether a credit hour program or a continuing education program.

Date(Required)

Month

Day

Year

Student Signature(Required)

Your Name
Your Name
Your Name

CAPTCHA

Application Information

Demographic Questions

Registration Information

Documentation

Citizenship, Refund, Tuition and Work Policies

SCHOLARSHIP AWARD ACCEPTANCE/VERIFICATION FORM

SC Wins Affidavit

Changing Majors

Admissions

Quick Navigation

Student Affairs

Address

Application Information

Demographic Questions

Registration Information

Documentation

Citizenship, Refund, Tuition and Work Policies

SCHOLARSHIP AWARD ACCEPTANCE/VERIFICATION FORM

SC Wins Affidavit

Changing Majors

Admissions

Quick Navigation

Student Affairs

Address

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